SURGICAL COMPLICATIONS AFTER MODULAR ENDOPROSTHETICS IN PATIENTS WITH ACETABULAR TUMOR

• Published in: Issledovaniâ i praktika v medicine Vol. 6; no. 3; pp. 98 - 107
• Main Authors: G. D. Iluridze, V. Yu. Karpenko, V. A. Derzhavin, A. V. Bukharov
• Format: Journal Article
• Language: English; Russian
• Published: QUASAR, LLC 05-09-2019
• Subjects: complications; pelvic bones; sarcomas; surgical treatment
• ISSN: 2410-1893
• DOI: 10.17709/2409-2231-2019-6-3-9

There are various methods of restoring the integrity of the pelvic ring, after surgery in patients with tumor lesions of the pelvic bones, allowing to keep the limb with good oncological and functional results. A new stage in the development of organ conservation treatment in this group of patients is the use of modular endoprostheses based on the conical leg. The development of postoperative complications leads to an unsatisfactory result of treatment, despite the radical surgery and technically correct endoprosthesis. This, in turn, leads to repeated surgical interventions, namely to remove metal structures, or to perform a crippling operation.Purpose. To analyze postoperative complications and methods of their treatment in patients after modular endoprosthesis replacement of the acetabulum.Patients and methods. From 2011 to 2018, surgical treatment of endoprosthesis using modular metal structures based on a conical leg was performed in 30 patients. There were 13 men (43%) and 17 women (57%). The median age was 45 years (23–63 years). Primary malignant tumors of pelvic bones were in 19 (63%) patients, 5 (17%) had a giant cell tumor. Two (7%) patients had solitary metastases of kidney cancer and one (3%) with synovial sarcoma, and 3 (7%) had relapses after previous surgical treatment.Results. The average follow-up period was 36 months. Progression of the disease in terms of 6 to 40 months was revealed in 10 patients (33%), 8 (27%) of which died, the remaining 22 (67%) are alive with no signs of progression. In the postoperative period, 11 (37%) patients developed complications with predominance (up to 30%) of infectious. The average functional result on the MSTS scale was 59%.Conclusion. The use of modular prostheses on the basis of a conical leg in patients with tumors of the pelvic bones allow to perform safe operations with a satisfactory functional and oncological result. The result obtained in our study is comparable with the data of world literature.